PMID- 34630684
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211012
IS  - 1792-1015 (Electronic)
IS  - 1792-0981 (Print)
IS  - 1792-0981 (Linking)
VI  - 22
IP  - 5
DP  - 2021 Nov
TI  - Skin anomalies in acromegalic patients (Review of the practical aspects).
PG  - 1330
LID - 10.3892/etm.2021.10765 [doi]
LID - 1330
AB  - Acromegaly is a hormonal disorder which occurs as the result of growth hormone 
      (GH) and insulin growth factor 1 (IGF-1) over-secretion; both hormones are 
      related to skin anomalies. The skin acts as a large endocrine organ, hosting GH 
      receptors in every cell while IGF-1 receptors are expressed only in 
      keratinocytes. This review is a literature review of skin anomalies found in 
      acromegaly, either related to the disease itself or associated with related 
      complications such as secondary diabetes mellitus, or involving associated 
      conditions such as genetic syndromes. The following clinical points are mentioned 
      as follows. Excessive skin and enlargement of soft tissue are due to 
      glycosaminoglycan deposits, edema, and hyperhidrosis (mostly facial and acral). 
      Acanthosis nigricans, a body fold dermatosis associated with insulin resistance, 
      involves local or diffuse hyperkeratotic plaques with or without 
      hyperpigmentation, caused by growth factors including GH/IGF-1. Other findings 
      include cherry angiomas (due to the effects of lipid anomalies on small vessels); 
      oily skin features with keratosis, epidermoid cysts, crochordons, 
      pseudo-acanthosis nigricans; a potentially higher prevalence of varicose veins 
      and psoriasis; low level of evidence for basal cell carcinoma, respective 
      hidroadenitis suppurativa has been noted. In addition, complicated uncontrolled 
      secondary diabetes mellitus (DM) may result in necrobiosis lipoidica 
      diabeticorum, diabetic dermopathy, skin bacterial infections, dermatological 
      complications of diabetic neuropathy, and nephropathy. Finally, associated 
      hereditary syndromes may cause collagenomas, fibromas/angiofibromas, lipomas in 
      multiple endocrine neoplasia type 1 (MEN1) syndrome; cafe-au-lait macules, early 
      onset neurofibromas, juvenile xanthogranuloma (involving non-Langerhans cell 
      histiocytes), and intertriginous freckling in neurofibromatosis type 1. Clinical 
      findings are differentiated from pseudo-acromegaly such as pachydermoperiostosis. 
      Iatrogenic rash, lipodystrophy (lipoatrophy with/without lipohypertrophy) are 
      rarely reported after pegvisomant/somatostatin analogues or after insulin use for 
      DM. Experiments using human cell lines have shown that GH/IGF-1 over-secretion 
      are prone to epithelial-to-mesenchymal transition (EMT) in melanoma. In 
      non-acromegalic subjects, the exact role of GH/IGF-1 in skin tumorigenesis is yet 
      to be determined. Skin in acromegaly speaks for itself, either as the first step 
      of disease identification or as a complication or part of a complex syndromic 
      context.
CI  - Copyright (c) 2020, Spandidos Publications.
FAU - Sandru, Florica
AU  - Sandru F
AD  - Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 
      050474 Bucharest, Romania.
AD  - Department of Dermatology, 'Elias' Emergency Hospital, 011461 Bucharest, Romania.
FAU - Popa, Adelina
AU  - Popa A
AD  - Department of Dermatology, 'Elias' Emergency Hospital, 011461 Bucharest, Romania.
FAU - Paduraru, Dan Nicolae
AU  - Paduraru DN
AD  - Department of General Surgery, 'Carol Davila' University of Medicine and 
      Pharmacy, 050474 Bucharest, Romania.
AD  - Department of General Surgery, University Emergency Hospital, 050098 Bucharest, 
      Romania.
FAU - Filipescu, Alexandru
AU  - Filipescu A
AD  - Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine 
      and Pharmacy, 050474 Bucharest, Romania.
AD  - Department of Obstetrics and Gynecology, 'Elias' Emergency Hospital, 022461 
      Bucharest, Romania.
FAU - Carsote, Mara
AU  - Carsote M
AD  - Department of Endocrinology, 'Carol Davila' University of Medicine and Pharmacy, 
      050474 Bucharest, Romania.
AD  - Department of Endocrinology, 'C. I. Parhon' National Institute of Endocrinology, 
      011863 Bucharest, Romania.
FAU - Ghemigian, Adina
AU  - Ghemigian A
AD  - Department of Endocrinology, 'Carol Davila' University of Medicine and Pharmacy, 
      050474 Bucharest, Romania.
AD  - Department of Endocrinology, 'C. I. Parhon' National Institute of Endocrinology, 
      011863 Bucharest, Romania.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210920
PL  - Greece
TA  - Exp Ther Med
JT  - Experimental and therapeutic medicine
JID - 101531947
PMC - PMC8495547
OTO - NOTNLM
OT  - IGF1
OT  - MEN1 syndrome
OT  - acanthosis nigricans
OT  - acromegaly
OT  - angiomas
OT  - dermatologic
OT  - diabetes mellitus
OT  - growth hormone
OT  - melanoma
OT  - skin
COIS- The authors declare that they have no competing interests.
EDAT- 2021/10/12 06:00
MHDA- 2021/10/12 06:01
PMCR- 2021/09/20
CRDT- 2021/10/11 05:57
PHST- 2021/07/12 00:00 [received]
PHST- 2021/08/11 00:00 [accepted]
PHST- 2021/10/11 05:57 [entrez]
PHST- 2021/10/12 06:00 [pubmed]
PHST- 2021/10/12 06:01 [medline]
PHST- 2021/09/20 00:00 [pmc-release]
AID - ETM-0-0-10765 [pii]
AID - 10.3892/etm.2021.10765 [doi]
PST - ppublish
SO  - Exp Ther Med. 2021 Nov;22(5):1330. doi: 10.3892/etm.2021.10765. Epub 2021 Sep 20.